Topic I/9) Erysipelas – clinical forms, complications and therapy

Question 1

Erysipelas

Answer 1

most superficial
involving the dermis and sometimes the upper subcutaneous layer of the skin.
affects the face and legs, and usually has a well-defined edge
elevated (plaque),
edematous
indurated.

Question 2

Cellulitis (Phlegmone)

Answer 2

a deeper infection
involving both the skin and deeper subcutaneous tissues.
affects the legs or arms, and may also affect one side of the face
s.aureus,Pneumococci, a variety of Gram (-)’s and Cryptococcus.

Question 3

differentiation of cellulitis from erysipelas

Answer 3

Cellulitis is usually not a raised lesion, and demarcation is not distinct
The tissue feels hard on palpation and is extremely painful.
overlying epidermis undergo bulla-formation or necrosis, resulting in epidermal sloughing and superficial erosion
abscess formation occurs, and even necrotizing fasciitis may develop

Question 4

Complications of Erysipelas/Cellulitis:

Answer 4

lymphangitis

necrotizing fasciitis

Question 5

Treatment of Erysipelas/Cellulitis:

Answer 5

1. Supportive – rest, elevation, analgesia, moist heat
2. Dressings – sterile saline dressings for removal of purulent exudate + necrotic tissue
3. Surgical – drainage of abscess if present, debridement of necrotic tissue
4. Antibiotics – Penicillin V in case of S.pyogenes, either IV or orally